Crossing the smoking divide for young adults: Expressions of stigma and identity among smokers and nonsmokers

Objectives: Denormalizing campaigns reframe smoking as an unappealing behavior, more likely to lead to social exclusion than inclusion. Social identity theory suggests this strategy will reinforce smoke-free norms and, as these become mainstream, decrease smoking prevalence. However, little is known about how these campaigns affect perceptions of smoking among young adult smokers and nonsmokers, or behavior toward smokers. A qualitative study was conducted to a) explore how smokers and smoking were perceived in an environment where smoking has become an increasingly unacceptable social behavior and b) examine whether and how this environment stigmatized smokers. Methods: About 14 group discussions and 4 in-depth interviews involving 86 participants, aged between 18 and 24 and of Maori, Pacific, and NZ European ethnicities, were conducted as part of a wider study examining young adults' responses to tobacco branding and plain packaging. Results: The themes identified illustrated how nonsmokers' perception of smoking as illogical and self-destructive supported harsh reactions, including stigmatizing behaviors that antagonized smokers. Nonsmokers, who recognized smoking's addictiveness, were more empathic and less judgmental of smokers. Conclusion: Including empathic content in smoking denormalizing campaigns may reduce judgmental reactions that inadvertently create a gulf between status of young adult smokers and nonsmokers. A supportive/empathic tobacco-control denormalization approach could enhance young adult smokers' willingness to make the transition from smoker to smoke free and elicit stronger support for their efforts from nonsmokers.